心脏再同步化治疗反应与左心室重构逆转的关系  

Relation of response to cardiac resynchronization therapy to left ventricular reverse remodeling

作　　者：Vidal B. Sitges M. Marigliano A. 苏畅(译) 杜媛(校) 

机构地区：[1]不详 [2]Thorax Clinic Institute, Hospital Clnic, University of Barcelona, Barcelona, Spain

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2006年第8期16-17,共2页

摘　　要：Cardiac resynchronization therapy(CRT) reverses left ventricular(LV) remodeling in patients with congestive heart failure. However, the mechanisms leading to the clinical response to CRT remain unclear. The aim of this study was to analyze whether patients who improve clinically have greater LV reverse remodeling than nonresponders after a 12-month follow-up period. The sample comprised 64 consecutive patients with heart failure, complete left bundle branch block, and LV ejection fractions(EFs) ≤ 35% who were treated with CRT. Doppler echocardiographic scans were taken just before and immediately after the implantation of the pacemakers and at 6- and 12-month follow-up examinations. LV diameters, volumes, and EFs were compared. Responders were defined as those patients who were alive without cardiac transplantation and with≥ 10% improvement in the 6-minute walking test after 1 year of follow-up. There were no clinical differences at baseline between responders and nonresponders. At 6- and 12-month follow-up, LV dimensions decreased significantly in responders but did not change in nonresponders. Furthermore, LVEFs improved only in responders. In conclusion, patients who clinically respond to CRT have greater LV reverse remodeling than nonresponders after 6 and 12 months of follow-up. The effect of CRT on LV remodeling may explain, at least in part, the clinical benefit of this therapy.Cardiac resynchronization therapy（CRT） reverses left ventricular（LV） remodeling in patients with congestive heart failure. However, the mechanisms leading to the clinical response to CRT remain unclear. The aim of this study was to analyze whether patients who improve clinically have greater LV reverse remodeling than nonresponders after a 12-month follow-up period. The sample comprised 64 consecutive patients with heart failure, complete left bundle branch block, and LV ejection fractions（EFs） ≤35% who were treated with CRT. Doppler echocardiographic scans were taken just before and immediately after the implantation of the pacemakers and at 6- and 12-month follow-up examinations. LV diameters, volumes, and EFs were compared. Responders were defined as those patients who were alive without cardiac transplantation and with ≥ 10% improvement in the 6-minute walking test after 1 year of follow-up. There were no clinical differences at baseline between responders and nonresponders. At 6- and 12-month follow-up, LV dimensions decreased significantly in responders but did not change in nonresponders. Furthermore, LVEFs improved only in responders. In conclusion, patients who clinically respond to CRT have greater LV reverse remodeling than nonresponders after 6 and 12 months of follow-up. The effect of CRT on LV remodeling may explain, at least in part, the clinical benefit of this therapy.

关 键 词：心脏再同步化治疗 治疗反应 重构逆转 左心室 充血性心力衰竭患者 完全性左束支传导阻滞 超声心动图检查 临床效果 

分 类 号：R541.62[医药卫生—心血管疾病] R733.3[医药卫生—内科学]